Senate Republican leadership just released an updated draft of the Better Care Reconciliation Act (BCRA). The most significant changes in the new bill include: leaving in place the Affordable Care Act's (ACA) lifting of the limit on Medicare payroll taxes and the tax on passive income; allowing the purchase of health insurance from a health savings account (HSA); changing the inflation factor for the Medicaid Per Capita Cap program from the medical care component of the consumer price index for all urban customers to just the consumer price index for all urban customers; including $45 billion instead of $2 billion to fight the opioid epidemic; and providing additional funding to help vulnerable populations purchase insurance.

It is yet to be seen whether these changes will allow Senate Majority Leader Mitch McConnell (R-KY) to get the necessary votes to proceed to the bill where further changes could be made on the Senate floor if necessary to garner 50 votes for passage. We are hearing multiple senators are exploring further policy options, negotiating both individually and in groups.

The section-by-section summaries of the updated bill, as prepared by committee staff, are available here (Titles I & II) and here (Title III).